Background: With increasing trends towards sedentary life style, obesity, diabetes mellitus, hypertension, and dyslipidaemia, the prevalence of metabolic syndrome (MetS) is rising in our country. In view of importance of diagnosis of MetS in day to day medical practice for early institution of life style therapies to reduce the atherosclerotic cardiovascular disease risk in susceptible population like in diabetes mellitus, this study has been undertaken to study the prevalence of metabolic syndrome in Nepalese diabetes by applying National Cholesterol Education Programme/Adult Treatment panel (NCEP/ATP) III and International Diabetes Federation (IDF) criteria.

Background: Hepatitis B vaccine is the single most effective and safest strategy for the prevention of the disease among health care workers (HCW), trainees and medical students. There is scanty information on knowledge, attitude and practice (KAP) regarding Hepatitis B vaccination among medical students who are likely to get exposed in the future as they start practicing. This study was undertaken to understand the knowledge, attitude and practice of hepatitis B vaccination among clinical medical students of Manipal College of Medical sciences at Pokhara, Nepal.Methods: Two hundred and four medical students were enrolled for an observational, cross-sectional study at Manipal College of Medical sciences at Pokhara, Nepal after obtaining ethical clearance from Institutional Review Committee. Answers to pre-tested questionnaire were collected. Knowledge, attitude and practice regarding Hepatitis B vaccination were studied. Results: All participants demonstrated good knowledge and positive attitude towards Hepatitis B infection and vaccination. However majority had poor practice towards it. Only 47.1% were completely vaccinated. The most common reason for non vaccination was that many thought they will vaccinate in internship or when they start practicing.Conclusion: Despite good knowledge and positive attitude towards Hepatitis B infection and vaccination, low rates of vaccination and poor practice was observed among HCW indicating the necessity of encouragement for vaccination and proper practices among them. All medical students should be immunized against Hepatitis B during their medical school. Regular Hepatitis B vaccination, educational and awareness programs must be conducted in coordination and with active participation of the medical students.Keywords: Attitude; Hepatitis B; knowledge; Medical students; Practice; Vaccination

Variceal bleeding was the leading cause of UGIB in Nepal followed by peptic ulcers and gastric erosion. Those variables of GBS and RS, which were significant predictors of adverse outcome for UGIB, can be utilized in determining more aggressive endoscopic management during endoscopy, or more prolonged intravenous proton pump inhibitor use, or an additional day or two of hospitalization.

Background and aims: The Helicobacter pylori (H. pylori) prevalence in Asian countries is highly variable, with higher seroprevalence shown in the previous studies of developing Asian countries. We aimed to determine the current H. pylori prevalence, correlate with gastroduodenal diseases and study gastric cancer incidence in Nepal. Methods: Among 3357 patients referred for endoscopy, 2820 eligible patients underwent upper gastrointestinal endoscopy with biopsy; H. pylori was considered positive when either of Rapid Urease Test (RUT) or histopathology showed positive result. Results: The H. pylori prevalence was 29.4% in overall distribution, 41.1% in gastritis and or duodenitis, 69.5% in gastric ulcer, 84.7% in duodenal ulcer, 20.8% in gastric polyp and 11.5% in gastric cancer. The H. pylori infection was significantly associated with gastritis and or duodenitis [P<0.001; Odds Ratio (OR) 1.53, 95% Confidence Interval (CI) 1.47-1.59], gastric ulcer (P<0.001; OR 18.62, 95% CI 12.40-27.81), duodenal ulcer (P<0.001; OR 48.89, 95% CI 25.23- 94.75), gastric polyp (P=0.001; OR 7.66, 95% CI 3.18-18.44) and gastric cancer (P=0.005; OR 3.78, 95% CI 1.82-7.86). The age-standardized (world) annual rate of gastric cancer in Kaski district of Nepal was 3.3 per 100,000. Conclusions: The H. pylori prevalence in Nepal was lower than that shown in the previous studies of developing Asian countries, but was significantly high in gastritis and or duodenitis, and peptic ulcers. Similarly, the gastric cancer incidence was also low in Nepal and was significantly associated with H. pylori. Further study is needed to establish the association of H. pylori with gastric cancer in Nepal. DOI: http://dx.doi.org/10.3126/jaim.v2i2.8777   Journal of Advances in Internal Medicine 2013;02(02):52-60